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Psychiatry 5th year, 2nd lecture (Dr. Hazhar)
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Psychiatry 5th year, 2nd lecture (Dr. Hazhar)

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The lecture has been given on May 10th, 2011 by Dr. Hazhar.

The lecture has been given on May 10th, 2011 by Dr. Hazhar.

Published in Health & Medicine
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  • 1. Substance(drug) abuse disorders- general part I
    Substance(drug) abuse disorders- general part I
  • 2. Substance abuse: It is a persistent use of one or more psychoactive substance.
    Dependence (addiction): untreated, persists and progresses, it ends in dependence: craving, tolerance, withdrawal symptoms, social and personal decline.medical complications .
  • 3. Craving: a strong and an irresistible desire.
    Tolerance: more amount of the drug to obtain the same effect (dose escalation).
    Physical dependence: withdrawal syndrome.
    Psychological dependence: urge to use the drug, thinks about it, likes it and he can not abstain.
  • 4. Personality factors: Predisposition to experiment with both licit and illicit drugs is more likely in those with sensation-seeking or impulsive behaviour traits, and in extroverts rather than in introverts.
    Herditary factors: alcoholic father.
    Age: Adolescence and puberty
  • 5. How abused drugs affect the brain?
    primary neurotransmitter:glutamatestimulatory ,gamma amino butyric acid(GABA) inhibitory, appropriate balance .
    Secondary transmitters:dopamine, serotonin, noradrenalin, acetylcholine, endogenous opiates, emotion to the primary processes.
    All drugs act by interfering with these neurotransmitters.
  • 6. Types according to the ICD-10: Alcohol, opiates, cannabinoids, sedatives (benzodiazepines and barbiturate), Stimulants (caffeine, amphetamine),cocaine, hallucinogens, nicotine , volatile substances (adhesives, aerosols, fuel gases, paints,multiple
  • 7. 1.Risk route of use: infection (hepatitis ,HIV), increased rate of brain entry,opiateintox. respiratory depression
    2.Risk of the drug itself.
    3.Addictiveness : opiates,cocaine. A. pleasure.b. physical suffering of abstinence.c.the psychological suffering, drug to relieve symotoms.
    4. Ease of stopping.
  • 8. Management
    1. precontemplation stage: there is no recognition of a need for treatment.
    2. contemplation stage: treatment is being considered, the patient is helped to clarify his views and to build his motivation to change.
    3 .Decision and action stage
  • 9.  
    Therapy
    1. medical complications:
    2. Treatment primary psychiatric disease if present.
    3. Psychotherapy, motivational interviewing, psycho education client-centered therapy, cognitive behavior therapy.
    4. Pharmacological , detoxification maintenance Therapy: aversion , anti-craving
  • 10. 4.Sociotherapy, family and marital therapy.
    5. Occupational therapy.
    6. Stress management and relaxation treatment.
    7.Relapse prevention.
    8. Self-help group